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Biomedical subjects

R L Rubin

Publications and source records attributed to R L Rubin.

At least 73 records · Page 4Linked to original sources
PubMed1988

HLA-DR2 association with excessive somnolence in narcolepsy does not generalize to sleep apnea and is not accompanied by systemic autoimmune abnormalities.

Recent reports that nearly all patients with narcolepsy have the HLA-DR2 phenotype suggest that autoimmunity may underly the etiology or pathogenesis of this disorder. Of 11 narcoleptic patients in the present study, 9 were HLA-DR2, confirming the strong association with this class II antigen but indicating that this is not an obligatory phenotype. In contrast only 3/10 patients with sleep apnea were HLA-DR2, suggesting that this form of excessive somnolence has a different etiopathogenesis. Significant levels of rheumatoid factor, antinuclear antibodies or autoantibodies to native DNA, denatured DNA, histones, Sjogren's syndrome B antigen, or Smith antigen were undetectable in sera from narcoleptic patients. Antibodies to rodent brain, primate brain stem, and neurocytotoxic antibodies were also not found. These results along with the absence of laboratory signs and clinical features of a systemic inflammatory process indicate that if narcolepsy is an autoimmune disease, the underlying lesion or pathologic condition may be confined to the central nervous system.

Adult↗
PubMed1987

Specificity and molecular characteristics of monoclonal IgM rheumatoid factors from arthritic and non-arthritic mice.

Two-hundred twenty-four hybridomas secreting monoclonal IgM rheumatoid factor (hIgMRF) derived from MRL-lpr/lpr, MRL-+/+ and C57BL/6-lpr/lpr autoimmune mice were analyzed with regard to IgG subclass and domain specificity, and some for VH gene expression patterns. Among these mice, only MRL-lpr/lpr develop arthritis. Clonotypes specific for each of the four mouse IgG subclasses and clonotypes reacting with more than one IgG subclass were identified. Although each panel contained several clonotypes, the predominant one differed in each strain (MRL-lpr/lpr, anti-IgG2a; MRL-+/+, combined anti-IgG2a and 2b; C57BL/6-lpr/lpr, anti-IgG1 or combined anti-IgG1, 2a, and 3). The IgG domains recognized by these monoclonals were defined with mutant Ig carrying IgG1 heavy chains that lacked either the CH1 or CH3 domains, variant Ig carrying hybrid IgG2b-2a heavy chains, and IgG fragments. Inhibition of hIgMRF binding to IgG substrates by protein A was also assessed. Most determinants were assigned to the CH3 domain, but determinants in the hinge region, CH2 domain, and in some instances, even in the Fab portion, could also be identified. Hybridization of cytoplasmic RNA from 35 classes of diverse IgG subclass specificity with VH gene probes representing seven of the approximately 10 VH families (7183, S107, Q52, J558, J606, 36-60, X24) indicated that approximately 90% of these clones expressed VH genes belonging to the large J558 gene family. The results indicate that murine IgMRF are extremely heterogeneous in IgG subclass and domain specificities; the genetic background influences RF specificity characteristics that may relate to pathogenicity; and considering the complexity of the J558 VH gene family and reported RF heavy chain assignments to additional VH gene families, it appears that VH genes encoding RF are diverse.

Animals↗
PubMed1987

Identification and isolation of soluble histones from bovine milk and serum.

An immunoassay for soluble histones as trace components of biological fluids was developed on the basis of the dual capacity of histones to bind solid-phase DNA and monoclonal anti-histone antibody. Application of this histone-capture assay to bovine milk resulted in a positive signal, and DNA-cellulose chromatography was used to isolate histone-like material in microgram quantities. Western-blot analysis using a panel of anti-histone antibodies demonstrated the presence of histones H2A, H2B and H4 in apparently intact form. DNAase digestion experiments indicated that at least a portion of milk histone was complexed to DNA. Bovine serum was analysed in the same manner on serial DNA-cellulose columns, and H4 and partially degraded H2A were detected by Western-blot analysis. The finding of soluble histones in bovine milk and serum may account for unexpected results when these biological fluids are used as blocking reagents in Western blots and other immunoassays and may have ramifications in the origin and significance of anti-histone antibodies in human disease.

Animals↗
PubMed1987

Monoclonal autoantibodies to nuclear antigens from murine graft-versus-host disease.

Systemic lupus erythematosus-like graft-versus-host (GVH) disease was induced in 10-week-old male (C57BL/10 X DBA/2) F1 mice by the intravenous injection of spleen and thymus cells (2:1) from 10-week-old male DBA/2 mice. GVH mice were bled at regular intervals 1 month after injection. Antibody to nuclear antigens (ANA) were detected by immunofluorescence using HEp-2 cells as substrate, and antibody to histones and DNA were detected by enzyme-linked immunosorbent assay (ELISA). The titer and frequency of ANA were found to relate directly to the number of donor cells injected. In order to determine the spectrum of ANA in GVH disease, mice were reinjected with optimum cell numbers (120 X 10(6], and splenocytes from two mice with high titer ANA were fused to mouse myeloma cell line P3/X63Ag8.653. Hybridomas were analyzed for ANA by immunofluorescence and ELISA. Sixty-eight clones were found which secreted ANA. Of these, 59% produced antibody to double-stranded DNA, single-stranded DNA, and/or histones and the remainder gave a variety of nuclear immunofluorescence patterns including speckled, homogeneous, nuclear matrix, and nucleolar. This study indicates that GVH disease provides an excellent source of splenocytes for the production of ANA-producing hybridomas as well as a model for the study of autoimmunity.

Animals↗
PubMed1987

Antihistone antibodies in systemic lupus erythematosus.

Antihistone antibodies are prevalent in systemic lupus erythematosus (SLE) and are the predominant autoantibody in patients treated with various drugs. Total histones consist of 5 classes and various histone-histone and DNA-histone complexes. Antibody binding to these various potential antigens has been measured by solid phase and Western blot immunoassays. Relatively unique profiles tend to characterize disease groups, but SLE sera were heterogeneous, displaying reactivity with only 1 to all 5 histones. Antihistone antibodies from human sera as well as murine monoclonal antibodies showed the capacity to react with more than 1 histone class. However, the fine specificities of antihistone antibodies were often assay dependent. Explanations for these discrepancies include degraded and impure histone preparations, irreversible denaturation and the role of soluble histones in biological fluids.

Antibodies, Antinuclear↗
PubMed1987

Cytotoxicity of oxidative metabolites of procainamide.

Indirect evidence suggests that metabolism of procainamide (PA) may be necessary for generation of its autoimmunity-inducing capacity. Reactive metabolites of PA produced by hepatic mixed function oxidases have been identified by their capacity to bind proteins covalently. The present study extends these findings by comparing the toxicity of various chemically synthesized metabolites of PA to a variety of cell lines and primary cultures. PA and its N-acetyl- and N-acetyl-N-oxide-derivatives were nontoxic to S49.1 cells at concentrations up to 5 mM, whereas nitro-Pa (4-nitro-N-(diethylaminoethyl)benzamide hydrochloride) and azoxy-PA (bis-N,N'-(diethylaminoethyl)-4,4'-azoxydibenzamide) displayed partial cytotoxicity at 1 and 0.1 mM, respectively. (The therapeutic range of PA is 0.02-0.05 mM.). In contrast, hydroxylamine-PA (4-hydroxylamino-N-(diethylaminoethyl)benzamide hydrochloride) was highly cytotoxic, producing a TD50 between 0.002 and 0.045 mM among the eight cell lines tested. Hydroxylamine-PA sensitivity correlated with cell reducing capacity, suggesting that redox cycling contributes to cytotoxicity. The hydroxylamine metabolite of PA undergoes spontaneous air oxidation to the nitroso-derivative (nitroso-PA). When this oxidation was minimized by rapid manipulations or inhibited by ascorbic acid, cytotoxicity was reduced or eliminated, suggesting that the nitroso-derivative may be the toxic metabolite. Quiescent peripheral blood lymphocytes, especially T-cells, were relatively insensitive to hydroxylamine-PA when evaluated by dye exclusion 1 day after drug exposure. However, massive DNA strand breaks were detectable in these cells immediately after drug exposure, and resting lymphocytes treated with 0.01 mM hydroxylamine-PA died slowly during the subsequent week.(ABSTRACT TRUNCATED AT 250 WORDS)

Ascorbic Acid↗
PubMed1986

IgG subclasses of anti-tetanus toxoid antibodies in adult and newborn normal subjects and in patients with systemic lupus erythematosus, Sjogren's syndrome, and drug-induced autoimmunity.

The IgG subclasses of anti-tetanus toxoid (anti-TT) antibodies were quantitated in normal sera and sera from patients with rheumatic disease. Detection relied on a set of four mouse monoclonal antibodies, each of which showed specificity for the respective isotype, independent of gamma-chain allotype or light chain class of the human antibody. Approximately 90% of the total anti-TT activity in normal adults and patients with Sjogren's syndrome was IgG1. In addition, IgG4 antibodies were detected in one-half the samples, but IgG2 and IgG3 antibodies were observed in only two out of 36 sera. However, antibodies elicited in children immunized with TT were exclusively IgG1 and IgG3, with IgG4 antibodies detectable only at birth (presumably due to transplacental passage of antibody) in three of 12 children. In contrast to normal adults, patients with systemic lupus erythematosus (SLE) and drug-induced autoimmunity (DIA) had a more promiscuous isotype profile. IgG2 and/or IgG3 anti-TT antibodies were detected in 13 of 22 SLE patients and IgG3 antibodies in six of 11 patients with DIA. IgG4 anti-TT antibodies were predominant in seven of these 33 patients. These findings suggest that IgG isotypes may depend on the frequency of the stimulus, but global alterations in immunologic status as reflected in systemic autoimmune disease may override the homeostatic mechanisms that control isotype restriction.

Adult↗
PubMed1986

IgG subclasses of autoantibodies in systemic lupus erythematosus, Sjogren's syndrome, and drug-induced autoimmunity.

The IgG subclasses displayed by autoantibodies were examined in patients with systemic rheumatic diseases. Solid-phase assays performed with purified antigens were combined with a set of four mouse monoclonal antibodies specific for each human subclass to provide quantitative data for all the major autoantibody specificities. IgG1 accounted for an average of 55% of the total antibody activity to native and denatured DNA, Sm antigen, and histone and constituted significantly more anti-SS-B and anti-nRNP (84% and 92%, respectively). The remaining antibody activity consisted largely of IgG3, and this subclass was particularly prominent with anti-histone and anti-Sm in patients with systemic lupus erythematosus. In contrast, IgG2 constituted 3 to 12% of the anti-native and anti-denatured DNA and less than 5% of the anti-SS-B/La activity in only three patients with Sjogren's syndrome. IgG2 was essentially undetectable in antibodies to Sm and RNP antigens. IgG4 was also uncommon, although this isotype was significantly more prevalent in anti-histone from patients treated with procainamide showed that the isotype distribution of anti-histone and anti-denatured DNA remained remarkably constant. However, during periods of large increases in autoantibody activity, a shift from predominantly IgG3 to predominantly IgG1 occurred, consistent with the interpretation that there might be a sequential activation of heavy chain constant regions as the immune response matures. The disproportionately high levels of IgG1 and IgG3 displayed by all the autoantibody specificities examined may indicate that a common immunogenic feature of autoantigens or a common control mechanism underlies the regulation of autoantibody expression.

Antibodies, Monoclonal↗
PubMed1986

Monoclonal antibody for DNA measurement in biological fluids.

Two highly sensitive immunoassays for measuring soluble DNA are described. These methods employ a purified mouse monoclonal anti-DNA antibody in enzyme-linked immunoassays. One assay is an antigen capture method utilizing immobilized antibody. Bound DNA is subsequently detected with biotinylated monoclonal anti-DNA antibody, avidin-coupled horseradish peroxidase and a chromogenic substrate. The limit of detection of the assay was 2 ng/ml of DNA. A competition assay relying on immobilized heat-denatured DNA was also designed. In this assay the solution to be analyzed is mixed in equal proportions with monoclonal anti-DNA antibody and the mixture is incubated in the DNA-containing microtiter plates. The inhibition of antibody binding as detected with peroxidase-conjugated anti-mouse IgG was proportional to the concentration of DNA in the sample. The competition assay was tested for its ability to detect DNA in human plasma. The detection limit of DNA in plasma was approximately 150 ng/ml. The assays were compared in their ability to detect various size fragments of DNA. The competition assay was capable of detecting DNA fragments as small as 30 base pairs. In contrast, the capture assay failed to detect low molecular weight fragments up to 150 base pairs although its sensitivity for undigested DNA was comparable to the competition assay. The assay may be of use in the rapid quantitation of low levels of DNA, especially low molecular weight DNA and may also be useful in measuring DNA in human plasma.

Antibodies, Monoclonal↗
PubMed1986

IgM anti-histone H-3 antibody associated with undifferentiated rheumatic disease syndromes.

A distinctive type of speckled antinuclear antibody staining pattern was identified by indirect immunofluorescence on mouse kidney substrate in 4.8% of 5,976 specimens analyzed for antinuclear antibodies. This pattern, termed variable large speckles (VLS), consisted of 3-10 nuclear speckles ranging in size from approximately 0.2-2.0 mu. The pattern could be differentiated from other indirect immunofluorescence patterns related to specific antibodies. The predominant immunoglobulin isotype demonstrating the VLS pattern was IgM in 27 of 28 sera examined and IgG in 1 serum. VLS sera had substantial IgM antibodies to histone demonstrated by enzyme immunoassay, and further analysis of representative sera showed predominant antibody activity to histone class 3 (H-3). Adsorption with histone H-3 resulted in decrease or removal of antibody producing the VLS pattern. Available information showed that most patients with IgM antibodies of the VLS pattern had undifferentiated connective tissue disease symptoms. They were characterized by a heterogeneity of chronic symptoms including arthralgias, myalgias, inflammatory polyarthritis, myositis, sicca symptoms, and pleurisy associated with elevation of the erythrocyte sedimentation rate. It remains to be determined whether the IgM anti-histone H-3 profile of these patients is a transient or long-standing serologic characteristic.

Animals↗
PubMed1986

Serologic changes during induction of lupus-like disease by procainamide.

Procainamide-induced lupus is a well-recognized syndrome, but the events leading up to clinical symptoms are obscure. In the present study, serologic changes in a 69-year-old man were monitored during his treatment with procainamide and after discontinuation of procainamide because of symptoms of drug-induced lupus. Antihistone antibodies of unique specificity and in vivo complement activation were detected after one year of procainamide therapy during a period prior to development of significant clinical symptoms. Antihistone antibodies and complement activation substantially increased during a full-blown episode of lupus-like symptoms. Progressive return to normal laboratory findings occurred after procainamide was discontinued. The antihistone/complement profile may be useful in the diagnosis of drug-induced lupus and warn of impending clinical deterioration in patients with minimal symptoms.

Aged↗
PubMed1986

Polynucleotide specificities of murine monoclonal anti-DNA antibodies.

Three IgM monoclonal anti-DNA antibodies were produced by hybridoma techniques from an MRL-lpr/lpr mouse using denatured DNA (dDNA) as the selection antigen. All three antibodies also bound poly(dT), poly(rA), and the single-stranded random copolymer poly(dI,dT), and each antibody displayed a unique preference for a limited array of other ribo- and deoxyribopolynucleotides based on direct binding as well as inhibition studies. Inability to identify a common primary structure in the polynucleotides reactive with each antibody suggested that higher ordered structures may be important. This notion was supported by the finding that oligomers of thymidine of 25-30 nucleotides or less were ineffective in blocking antibody binding to dDNA or poly(dT). However, deliberate destabilization of putative secondary structures by decreasing counterion concentration and increasing temperature had little effect on antibody binding to poly(dT). Since the antigenic polynucleotides in general contain little known secondary structure and considerable flexibility, antibody binding may be accompanied by local conformational changes in the polynucleotide that result in a better fit to the antibody combining site.

Animals↗
PubMed1986

Procainamide elicits a selective autoantibody immune response.

The specificity of the in vivo humoral immune response elicited by procainamide was examined by solid-phase assays, immunofluorescence, immunoprecipitation and a cytotoxicity assay. Serial samples obtained from patients during their procainamide therapy showed a progressive increase in antibodies to histones and denatured DNA, and both activities decreased after discontinuation of therapy. In contrast antibodies to tetanus, human IgG (rheumatoid factor) and heterologous lymphocytes were unaffected by procainamide treatment, indicating that they were not drug-induced. Of 29 sera examined by protein-A-facilitated immunoprecipitation, four sera had antibody to ribosomal RNA and three sera immunoprecipitated a 40kD protein. Antinuclear antibodies were invariably present but absorption studies showed that these activities were due to anti-histone antibodies. These results indicate that procainamide-induced autoimmunity is characterized predominantly by an anti-histone and anti-denatured DNA immune response.

Antibodies, Antinuclear↗
PubMed1986

Assisting adolescents toward mental health.

The developmental stage of adolescence may be so turbulent as to require psychiatric intervention. The adaptive difficulties experienced by Offer's tumultuous group of adolescents were once considered normal problems for that age group. Now they are considered to be a precursor to more serious psychosocial problems and require entry into the mental health care system. The adolescent psychiatric patient may experience adaptive difficulties, such as delinquency, substance abuse, and sexual acting out, or a diagnosed psychiatric disorder. The level of care an adolescent requires depends upon the type and severity of his dysfunction. Early detection and prevention is largely accomplished through education. Assessment and crisis intervention require the structure of an acute care inpatient setting. Long-term treatment may be necessary to provide a corrective emotional experience for the severely dysfunctional adolescent. Research endeavors should be directed toward further exploration of the relationship between adaptive difficulties and adult psychiatric disorder. Outcome studies would be helpful in evaluating the success of psychiatric nursing intervention at multiple levels of complexity.

Adaptation, Psychological↗
PubMed1985

Drug-induced lupus. Genetic, clinical, and laboratory features.

Drug-induced lupus is a disorder similar to idiopathic systemic lupus erythematosus in terms of manifestations. However, these entities have significant serologic and clinical differences, which call into question the concept that they represent an identical disease process. Nonetheless, further research into the drug-induced disease will enhance our understanding and management of this clinically significant iatrogenic disease and will likely contribute to our comprehension of the pathogenesis of autoimmunity.

Aged↗
PubMed1985

IgG antibodies to the histone complex H2A-H2B characterize procainamide-induced lupus.

Patients treated with procainamide and other drugs commonly develop antinuclear antibodies and occasionally symptoms of lupus erythematosus. However, the pathological events which lead to clinical symptoms in some patients but only abnormal serology in others have not been established. The present study examines the incidence, amount, immunoglobulin class, and antigen-binding specificity of anti-histone and anti-denatured DNA (anti-dDNA) antibodies in three groups of patients. These comprised a prospective study of patients treated with procainamide, patients with clinical drug-induced lupus symptoms, and a group undergoing therapy for many years without any symptoms. Procainamide elicited IgG and IgM anti-dDNA antibodies concordantly. Anti-histone IgM antibodies also appeared de novo during this period but IgG anti-histone antibodies were detected less frequently. Asymptomatic patients tended to have an antibody profile consisting of highly elevated anti-dDNA, IgM antibodies reactive with all histones and IgG antibodies specific for only one or two histone classes. In contrast symptomatic patients usually had little anti-dDNA or antibodies to individual histones but had pronounced IgG antibodies to the histone complex H2A-H2B. This unique antibody was characteristics of procainamide-induced lupus and was not detected in patients whose disease was induced by hydralazine. Anti-(H2A-H2B) decreased after procainamide was discontinued, concomitant with subsidence of symptoms. The finding that autoantibodies elicited by procainamide in patients with lupus symptoms have a characteristic immunoglobulin class and specificity may be of pathogenic significance and suggests that patients susceptible to procainamide-induced lupus have a unique immune response. In addition, this information could be of diagnostic value in predicting which procainamide-treated patients will develop overt symptoms of lupus.

Adult↗
PubMed1984

Multiple autoantigen binding capabilities of mouse monoclonal antibodies selected for rheumatoid factor activity.

We report that approximately 1/4 of monoclonal rheumatoid factors produced by hybridomas derived from fusions of spleen cells from MRL/lpr/lpr mice with systemic lupus erythematosus (SLE) and arthritis exhibited multiple reactivities with other autoantigens, including dDNA , histones, and/or cytoskeletal-cytoplasmic elements. The patterns of reactivities of most of these clones differed, indicating that each had a separate B cell ancestor. Studies with eluted antibodies demonstrated that a single species of antibody molecules was responsible for the observed multiple reactivities. Inhibition experiments suggested that an antibody combining site may be large enough to accommodate dissimilar epitopes. These findings may provide further insights into the generation and extent of antibody diversity as well as the etiopathogenesis of systemic autoimmune diseases.

Animals↗